What is Physiotherapy?

by Hugh StJ. Hunter

With more moving parts than any other machine, it is not surprising that your body occasionally cries out in pain or refuses to do what you tell it. There are hundreds of different muscles and joints that can go wrong.

Fortunately, there is an effective way to treat many of the problems you may experience – physiotherapy.

Physiotherapy uses a variety of techniques to help your muscles and joints work to their full potential, helping to repair damage by speeding up the healing process and reducing pain and stiffness.

Physiotherapists also have an important role in rehabilitation, such as helping people who have had strokes to relearn basic movements.

Physiotherapists do not simply offer treatment - their advice can help you prevent problems returning or even happening in the first place.

Physiotherapy may be of benefit to everyone from infancy to extreme old age.

After Surgery

Many people first encounter a physiotherapist post-operatively, particularly following orthopaedic surgery. An exercise regime and other treatments can greatly assist following a fracture or joint replacement and valuable help with walking or mobilising a damaged upper limb can also be offered.

People suffering with other musculoskeletal disorders, sports injuries, spinal problems, joint or muscle pain, arthritis, etc. are treated in a variety of ways including exercises, mobilisations, manipulation, hydrotherapy, acupuncture and electrotherapy. Many receive treatment at out patient clinics, while outreach physiotherapists visit people at home if they are unable to travel.

Many other post-operative patients are also greatly aided by physiotherapy. Specialist areas of work include intensive care, high dependency and urology but any surgery requiring a general anaesthetic may adversely affect the respiratory system, so an early visit from a physiotherapist can help prevent chest problems after surgery.

Physiotherapists also work with those with vascular conditions and, when amputation is involved, regular physiotherapy sessions can help all ages to learn to lead normal, active lives with their prosthetic limbs.

Women’s Health

Women can benefit from both advice and treatment during pregnancy and in the early post natal period. Many physiotherapists also participate in parent craft classes in partnership with midwives. In addition, pre- and post-operative advice and exercises can aid recovery following gynaecological surgery while specialist advice and treatment can help greatly with incontinence, an embarrassing problem which can affect women of all ages.

Another condition which can benefit from regular physiotherapy is lymphoedema, particularly after breast surgery with treatments such as manual lymphatic drainage, helping with swelling and discomfort.

Other Conditions

Many medical conditions can also benefit from physiotherapy, such as chronic chest problems. Others requiring support include stroke victims, or those experiencing difficulties in walking following an enforced period of bed rest. Many parts of the country have stroke support groups as well as cardiac rehabilitation and pulmonary rehabilitation classes where a physiotherapist will provide a variety of treatment methods, exercise regimes and walking aids plus again much needed advice and encouragement.

Other disabling conditions which can benefit are Multiple Sclerosis, head and spinal injuries, osteoporosis and even neurological disease. In aiming to achieve maximum physical potential for these patients, the physios advise on the management of problems such as pain and muscle spasms.

For some people, physiotherapy is something that happens once in a lifetime; for others it is an ongoing process covering weeks, months and even years. Whether as a pain reliever, a mobiliser or simply an advisor, the physiotherapist has much to offer.

CASE STUDY

A 43-year-old female librarian was referred for physiotherapy with a five month history of right shoulder and arm pain. She reported that each night she was wakened with severe pain ‘like toothache’ and was unable to lie on the shoulder. Any sudden movement caused instant severe pain. Functionally she was unable to put her hand behind her back to fasten her clothing and could not wash or dry her hair, while at work she was unable to reach up to shelves.

Her GP had prescribed a course of anti-inflammatory drugs and sent her for an X-ray, which showed only mild degeneration in her neck and a slight narrowing of the disc space between C5/C6. As the treatment had proved ineffective after one month, he referred her for a physiotherapy assessment. This demonstrated that the patient had a definite Capsulitis (Frozen Shoulder), her pain and limitation of movement following a well-defined and recognised pattern.

A technique called passive mobilisations was used. This is designed to increase the patient ’s shoulder movements while reducing the pain. The physiotherapist moves the arm and shoulder in a way that will stretch the capsule of the shoulder joint with very precise graded movements.

The patient also received heat treatment to soothe the joint and prevent a post-mobilisation flare up of pain. In addition, she learned a programme of active exercises to be carried out as often as possible, without causing further trauma to the shoulder.

The importance of performing these exercises was stressed.

The overall purpose of this treatment was to stretch the shrunken capsule to break the adhesions that have formed.
Once her range of movement was restored and the pain stopped, she was encouraged to begin exercises to strengthen the shoulder and stabilise the shoulder blade, so minimising any reoccurrence.

Treatment of a Frozen Shoulder is just one of the areas in which physiotherapy has an important role to play in equal partnership with the patient, as it is vital that the home exercises are performed diligently.